Cardiovascular disease

[9][10] Prevention of CVD involves improving risk factors through: healthy eating, exercise, avoidance of tobacco smoke and limiting alcohol intake.

[27] Most common cardiovascular diseases are non-Mendelian and are thought to be due to hundreds or thousands of genetic variants (known as single nucleotide polymorphisms), each associated with a small effect.

[3] The risk of ischemic heart disease and diabetes mellitus is reduced by almost a third in adults who participate in 150 minutes of moderate physical activity each week (or equivalent).

The World Health Organization attributes approximately 1.7 million deaths worldwide to low fruit and vegetable consumption.

African-Americans report experiencing short durations of sleep five times more often than whites, possibly as a result of social and environmental factors.

Psychosocial factors, environmental exposures, health behaviours, and health-care access and quality contribute to socio-economic differentials in cardiovascular disease.

Currently, airborne particles under 2.5 micrometers in diameter (PM2.5) are the major focus, in which gradients are used to determine CVD risk.

[63] Other diagnostic tests and biomarkers remain under evaluation but currently these lack clear-cut evidence to support their routine use.

They include family history, coronary artery calcification score, high sensitivity C-reactive protein (hs-CRP), ankle–brachial pressure index, lipoprotein subclasses and particle concentration, lipoprotein(a), apolipoproteins A-I and B, fibrinogen, white blood cell count, homocysteine, N-terminal pro B-type natriuretic peptide (NT-proBNP), and markers of kidney function.

[67] Moreover, posttraumatic stress disorder is independently associated with increased risk for incident coronary heart disease, even after adjusting for depression and other covariates.

[68] Little is known about the relationship between work and cardiovascular disease, but links have been established between certain toxins, extreme heat and cold, exposure to tobacco smoke, and mental health concerns such as stress and depression.

[69] A 2015 SBU-report looking at non-chemical factors found an association for those:[70] Specifically the risk of stroke was also increased by exposure to ionizing radiation.

[70] A 2017 SBU report found evidence that workplace exposure to silica dust, engine exhaust or welding fumes is associated with heart disease.

[71] An association was also found between heart disease and exposure to compounds which are no longer permitted in certain work environments, such as phenoxy acids containing TCDD(dioxin) or asbestos.

There is evidence that workplace exposure to lead, carbon disulphide, phenoxyacids containing TCDD, as well as working in an environment where aluminum is being electrolytically produced, is associated with stroke.

Several large-scale research projects looking at human genetic data have found a robust link between the presence of these mutations, a condition known as clonal hematopoiesis, and cardiovascular disease-related incidents and mortality.

[87] Additionally echocardiography, myocardial perfusion imaging, and cardiac stress testing is not recommended in those at low risk who do not have symptoms.

[89][90] Ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP), and coronary artery calcium, are also of unclear benefit in those without symptoms as of 2018.

The number and variety of risk scores available for use has multiplied, but their efficacy according to a 2016 review was unclear due to lack of external validation or impact analysis.

[142][143] A 2020 systematic review found moderate quality evidence that reducing saturated fat intake for at least 2 years caused a reduction in cardiovascular events.

[146] A diet high in trans fatty acids is associated with higher rates of cardiovascular disease,[147] and in 2015 the Food and Drug Administration (FDA) determined that there was 'no longer a consensus among qualified experts that partially hydrogenated oils (PHOs), which are the primary dietary source of industrially produced trans fatty acids (IP-TFA), are generally recognized as safe (GRAS) for any use in human food'.

[156] Intermittent fasting may help people lose more weight than regular eating patterns, but was not different from energy restriction diets.

[166] Niacin, fibrates and CETP Inhibitors, while they may increase HDL cholesterol do not affect the risk of cardiovascular disease in those who are already on statins.

Exercise-based cardiac rehabilitation following a heart attack reduces the risk of death from cardiovascular disease and leads to less hospitalizations.

Low-quality evidence from a limited number of studies suggest that yoga has beneficial effects on blood pressure and cholesterol.

[193] Proper CVD management necessitates a focus on MI and stroke cases due to their combined high mortality rate, keeping in mind the cost-effectiveness of any intervention, especially in developing countries with low or middle-income levels.

[94] Regarding MI, strategies using aspirin, atenolol, streptokinase or tissue plasminogen activator have been compared for quality-adjusted life-year (QALY) in regions of low and middle income.

[194] Aspirin, ACE inhibitors, beta-blockers, and statins used together for secondary CVD prevention in the same regions showed single QALY costs of $350.

[199] The causes, prevention, and/or treatment of all forms of cardiovascular disease remain active fields of biomedical research, with hundreds of scientific studies being published on a weekly basis.

Recent areas of research include the link between inflammation and atherosclerosis[200] the potential for novel therapeutic interventions,[201] and the genetics of coronary heart disease.

Disability-adjusted life year for inflammatory heart diseases per 100,000 inhabitants in 2004 [ 16 ]
No data
Less than 70
70–140
140–210
210–280
280–350
350–420
420–490
490–560
560–630
630–700
700–770
More than 770
Calcified heart of an older woman with cardiomegaly
Density-Dependent Colour Scanning Electron Micrograph SEM (DDC-SEM) of cardiovascular calcification, showing in orange calcium phosphate spherical particles (denser material) and, in green, the extracellular matrix (less dense material) [ 78 ]
Cardiovascular diseases deaths per million persons in 2012
318–925
926–1,148
1,149–1,294
1,295–1,449
1,450–1,802
1,803–2,098
2,099–2,624
2,625–3,203
3,204–5,271
5,272–10233
Disability-adjusted life year for cardiovascular diseases per 100,000 inhabitants in 2004 [ 16 ]
no data
<900
900–1650
1650–2300
2300–3000
3000–3700
3700–4400
4400–5100
5100–5800
5800–6500
6500–7200
7200–7900
>7900